Surgical instrument



1940? J. L. MONTALVO-GUENARD 2,224,575

SURGICAL Filed J1me I3, 1939.

On i w Patented Dec. 10, 1940 UNITED STATES PATENT OFFICE 1 Claim.

. This invention relates to surgical instruments and is concerned more particularly with a novel attachment which may be employed with a syringe to produce an instrument by means of which the surgeon may securely hold and readily manipulate the eye lens, although the instrument makes contact therewith over only a relatively small area. The instrument produced by the use of the attachment of the invention may be employed to special advantage in operations on the eye for removal of the crystalline lens in cases of cataracts, and an embodiment of the principles of the invention adapted for that operation will be described in detail for purposes of explanation.

In operations on the crystalline lens, the technique employed involves making an incision through the cornea adjacent the limbus to provide an opening. The lens is then removed either by the classic operation involving application of counterbalanced pressure to the surface of the eyeball or by the insertion of special forceps through the incision and through the pupil tograsp the lens. Certain types of cataract can be removed by these methods only with great difiiculty and possible injury to the iris and the deeper structures of the eye, such injuries arising in one case from the extreme pressures required, and in the other from the liability of the iris being pinched and torn loose. Also, when forceps are used, the anterior portion or capsule of the lens may be torn by the gripping ends of the forceps, because of the difficulty of securing a good grasp with that type of instrument, especially in cases where the capsule is very fragile.

The present invention is accordingly directed to the provision of an attachment which may be employed with a syringe to produce an instrument by which a part of the body, such as the lens of the eye, may be securely held and readily manipulated and removed, despite the fact that the instrument makes contact with the part over a small area on one surface only. The new attachment comprises a valve including a body having a hollow extension from one side into which may be inserted the nozzle of a syringe. Extending from the other side of the valve body is a cannula terminating in a contact member, preferably in the form of a small spoon, and the valve has a handle by which it may be readily opened or closed. When the attachment is mounted on the syringe nozzle, the syringe may be operated to apply suction to the concavity of the spoon and the suction effect can be regulated or destroyed, as desired, by manipulation of the valve.

For a better understanding of the invention, reference may be made to the accompanying drawing in which: 5

Fig.1 is a view partly in plan and partly in longitudinal section of one form of the instru-- ment produced by the use of the attachment of the invention;

Fig. '2 is a fragmentary side elevation of the device shown in Fig. 1;

Fig. 3 is a sectional view on the line 3-3 of Fig. 1;

Fig. 4 is a view in side elevation of a part of the valve of the instrument;

Fig. 5 is a view in side elevation of another part of the valve;

Fig. 6 is a plan view of an instrument of modified construction; and- Fig. 7 is a view of certain parts employed in the instrument of Fig. 6 and shown in disassembled relation.

. Referring to the drawing, the instrument produced by the form of, the novel attaclnnent is illustrated in Fig. 1 as including a syringe consisting of a cylinder I0 containing a piston ll, these parts being made of any suitable material and advantageously formed of glass. As illustrated, the piston extends out one end of the cylinder and the other end of the cylinder, is closed and is provided with a nozzle l2 having a passage [3 therethrough into the interior of the cylinder. If desired, a spring I4 may be employed within the cylinder, the spring tending to force the piston away from the closed end thereof.

The attachment is mounted on the end of the nozzle I2 and it includes a valve, generally designated 15 and including a body IS with a lateral recess and a rotatable plug [1 within the recess. The plug is of frusto-conical shape and has a passage 18 therethrough and the valve body is provided with passages l9 and 20 leading to the lateral recess, these passages being connected by the passage l8 when the plug is in proper rotational position. The end of the plug lying outside the recess is formed with the circumferential channel 2| and the plug is held in position in the valve body by a U-shaped clip 22 having a bifurcated end 23, the legs 24, of which, lie on either side of the axis of the plug within the channel. The clip extends along the bottom of the valve body and its other end 25 bears against the side of the body opposite to that in which the recess is formed. The plug is also provided with a handle 26 terminating in a finger piece 21, the handle being bent so that the finger piece overlies the top of the valve.

The valve body is provided with a hollow extension 28 which fits snugly over the end of the nozzle 12 on the cylinder, and from the opposite side of the body extends a small tube or cannula 29, which may be bent at a suitable angle for convenience in use. At the end of the tube is a concave contact member 30,.which for convenience, may be referred to as a spoon and with the concavity of which the interior of the tube communicates. Preferably, the valve body, the cannula, and the spoon are of integral construction and the end portion of the cannula and the spoon are made of platinum so that they can be sterilized in an alcohol flame.

In the modified construction shown in Fig. 6, the instrument produced by the use of the attachment includes a syringe consisting of a cylinder 3! containing a piston 32. A spring 33 encircles a portion of the piston lying outside the cylinder and bears at one end against the flanged end 34 of the cylinder and at the other against an end flange 35 on. the piston. The cylinder is provided with anozzle 36 which enters a. hollow extension 37 on a valve 38, of the same construction as the vvalve I5. From the side of the valve, opposite to that from which extension 3'! projects, the valve body is provided with a hollow extension 39 which enters. a recess in a tube or cannula/40, terminating in a spoon 4!.

In the use of the instrument, an incision is made in the eyeball vin'the usual manner and the instrument is then made ready for use. For

this purpose, the valve is opened and the piston is forced into the cylinder until the spring is completely compressed, whereupon the valve is closedand the piston released. The spring forces the piston out of the cylinder until the suction acting on the piston balances the force-of the spring. With the valve thus closed, the can,- nula is .inserted through the incision and the concave side of the spoon applied to the anterior surface of the lens. The valve is-then opened and the reduced pressure within the cylinder causes suction to be appliedthrough the cannula and spoon to the capsule and lens, and this suction is sufficient to hold the capsule and lens firmly against the concave side of the spoon. Thereafter the instrument is manipulated in the usual way to free the lens andremove it, after which a slight inward movement on the piston sumces to release the lens from the spoon.

The instrument produced by the use of the new attachment thus provides the surgeon with means by which he may hold and manipulate the eye lens without disturbance of the adjacent parts. In eye operations, this feature is particularly important since the contact member of the instrument may be applied to the central area of the anterior surface of the lens without exerting severe pressure on the vitreous humor and with no possibility of injuring the iris. Also the amount of suction available is limited and the instrument is always under close control.

In the instrument produced by the use of the new attachment, the amount of suction applied depends to some extent on the strength of the spring acting on the piston, and springs of differ ent strengths may be employed for different purposes. Preferably the'spring is employed for forcing the piston out of the cylinder since it simplifies the use of the instrument and permits the application of the suction to beaccomplished under the-control of the valve handle only. As will .be seen, the valve and its handle are so dis posed that the instrument may be held by the surgeon between the thumb and middle finger and the valve handle is then in convenient position for manipulation by the index finger. The instrument can thus be used and operated with one hand only;

I claim:

. An attachment for use with a syringe having a nozzle which comprises a body having a hollow extension from cneside adapted to receive the nozzle, a rigid tube leading from the opposite side of the body and having an upward bend, a spoon on the end of the tube with its concavity in communication with the interior of the tube, a passage through the body connecting the interior of the extension and the tube, a valve member in the body controlling communication between the interior of the extension and tube, and a, handle attached to the valve member for operating the latter and bent to overlie the top oflthe body.

JOSE LEANDRO MONTALVO-GUENARD. 

